Acne vulgaris

"Secondary acne scars are treated in the Clinic with chemical peelings, dermabrasion or CO2 laser, techniques that achieve very good results".

DR. PILAR GIL SÁNCHEZ
SPECIALIST. DERMATOLOGY DEPARTMENT

Acne is a skin disorder caused by inflammation of the sebaceous gland and hair follicle. The germs, present in the skin, cause an infection of that area with the consequent inflammatory response and the typical appearance of the lesions.

Acne is also influenced by hormonal, hereditary and psychological factors that increase excess oil in the sebaceous gland.

In general, it affects adolescents and young adults, and tends to resolve over the years. Specifically, in young men it tends to resolve between the ages of 20-25; while in women, it can persist until the ages of 30-40.

The most unfavorable prognostic factor is the presence of deep residual scars, which may remain permanently.

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What are the symptoms of acne?

Acne manifests itself clinically with various types of lesions, and several of them may be present in the same patient.

The most common symptoms of acne are:

  • Cysts on the skin
  • Comedones
  • Pustules
  • Scars

Acne lesions can be inflammatory or non-inflammatory.

  • Non-inflammatory: closed and open comedones "blackheads".
  • Inflammatory: reddish papules, pustules, nodules and cysts.

Cystic acne, which forms nodules and cysts, requires special attention as they may leave residual scars, which are the most important sequelae of acne.

Some patients may present more severe forms of acne associated with fever and poor general condition (acne fulminans) and require early systemic treatment.

Do you have any of these symptoms?

You may have acne

What are the causes of acne?

Acne vulgaris appears when the hair follicles of the skin become clogged by the presence of oil or dead cells.

Acne is not directly caused by fat in the diet but, sometimes, the person relates it to certain foods such as chocolate, etc. In such cases, the consumption of these foods should be restricted.

Its appearance is mainly influenced by five factors:

  1. Obstruction of the pilosebaceous canal of the hair follicle due to alterations in the keratinization of the stratum corneum of the skin.
  2. Increased secretion of the sebaceous glands. 
  3. Alterations in the bacterial microflora of the skin with the presence of microorganisms such as Propionibacterium acnes.
  4. Release of inflammatory mediators in the sebaceous hair follicle.
  5. Hormonal variations, in particular the presence of androgens.

How does acne evolve?

Acne vulgaris is, in general, a pathology that affects adolescents and young adults and tends to resolve over the years.

Juvenile acne in young men tends to resolve between 20-25 years of age, while in women it may persist until 30-40 years of age.

The most unfavorable prognostic factor appears in cystic acne and is the presence of deep residual scars, which may remain permanently.

Acne during pregnancy may appear sporadically due to the hormonal changes that occur during this stage. It is usually enough to take special care of the skin cleanliness and only in the case of no improvement, the specialist should be consulted to evaluate topical pharmacological treatment.

How is acne treated?

It is important to evaluate the type and degree of acne to avoid the aesthetic consequences

Mild acne
Topical treatment is performed with exfoliants (elemental sulfur, salicylic acid, glycolic acid), benzoyl peroxide, azelaic acid and retinoids (tretinoin, isotretinoin and adapalene).

Moderate acne
Topical treatment is performed with benzoyl peroxide, retinoids and antibiotics (clindamycin, tetracycline and erythromycin base).

Severe acne
In these cases it is necessary to perform systemic treatment with systemic antibiotics (tetracyclines) for 3 to 6 months. Systemic retinoids (isotretinoin) administered for approximately 5 months allow a complete cure in almost all patients. In some patients it is necessary to administer more than one cycle of treatment.

Very severe acne

  • Systemic treatment: Isotretinoin associated with systemic corticoids or administered directly to the lesions.
  • Surgical treatment: Drainage of cysts or mechanical removal of comedones as complementary treatments.

There are different dermatological treatments to eliminate secondary acne scars, which usually appear when there is cystic acne. These treatments should be performed as long as there are no active acne lesions.

Among others, we have chemical peelings with glycolic acid or other somewhat more aggressive methods such as dermabrasion or CO2 laser, which allow us to improve the appearance of patients.

Patients who present proven hormonal alterations (high androgen levels) can benefit from anti-androgenic treatments or through estrogens associated with progesterone.

Where do we treat it?

IN NAVARRE AND MADRID

The Department of Dermatology
of the Clínica Universidad de Navarra

The Department of Dermatology of the Clinica Universidad de Navarra has extensive experience in the diagnosis and treatment of dermatological diseases.

We have extensive experience in highly precise surgical treatments, such as Mohs surgery. This procedure requires highly specialized personnel. 

We have the latest technology for the dermo-aesthetic treatment of skin lesions, with the aim of achieving the best results for our patients.

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Why at the Clinica?

  • Experts in Mohs Surgery for the treatment of skin cancer.
  • We have the best technology for dermo-aesthetic treatments.
  • Safety and quality assurance of the best private hospital in Spain.

Safer than ever to continue taking care of you

We update safety protocols weekly with the latest scientific evidence and the knowledge of the best international centers with which we collaborate.